FACULTY OF MEDICINE PHASE IV INTERNAL MEDICINE CLERKSHIP

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YEDİTEPE UNIVERSITY

FACULTY OF MEDICINE

PHASE IV

INTERNAL MEDICINE CLERKSHIP

LECTURERS

DISCIPLINE FACULTY

ENDOCRINOLOGY

Hasan AYDIN, MD Prof.

Fahrettin KELEŞTİMUR, MD Prof.

GASTROENTEROLOGY

Meltem ERGÜN, MD Prof.

Cengiz PATA, MD Prof.

HEMATOLOGY Hasan Atilla ÖZKAN, MD Assoc. Prof.

INTERNAL MEDICINE

Yaşar KÜÇÜKARDALI, MD Prof.

Arzu YALÇIN, MD

MEDICAL ONCOLOGY

Okan KUZHAN, MD Prof.

Mehmet ALİUSTAOĞLU, MD Assoc. Prof.

Şermin MEŞE, MD

RESPIRATORY SYSTEM

Sevda ÖZDOĞAN, MD Prof.

Banu Musaffa SALEPÇİ, MD Assoc. Prof.

Seha AKDUMAN, MilD,

NEPHROLOGY

Gülçin KANTARCI, MD Prof.

Dek BARUTÇU ATAŞ, MD

RHEUMATOLOGY Müge BIÇAKÇIGİL KALAYCI, MD Prof.

HAYDARPAŞA NUMUNE TRAINING AND RESEARCH

HOSPITAL (HTRH)

Refik DEMİRTUNÇ, MD Prof.

Funda TÜRKMEN, MD Prof.

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AIM AND LEARNING OBJECTIVES OF


AIM

Aim of this clerkship is to;

1. remind necessary knowledge, related to body systems, on prevention of clinical conditions’ emergence,

protection and improvement of health in healthy conditions,

2. at multi-system level or related to a body system, for clinical conditions which are frequent in community

and/or pose high risk for individual or community health, and/or life-threatening or constitute an

emergency

2.1. remind necessary knowledge on risk factors, etiopathogenesis, physiopathology, and pathology,

2.2. remind knowledge on epidemiology,

2.3. remind knowledge on frequently encountered clinical complaints, symptoms, signs and findings,

3. remind necessary knowledge on health care processes, clinical decision making process, clinical

decisions and clinical practices, with performance measures, for managing at the level of primary health

care service,

4. remind knowledge on pharmacology of drugs that are effective at multi-system level, specifically on a

body system or on clinical conditions involving a specific body system,

5. equip students with necessary knowledge, skills and attitudes required for an appropriate Approach to

healthy and sick adults,

6. convey necessary knowledge on preventive healthcare measures,

7. equip students with necessary knowledge, skills and attitudes required to achieve diagnosis and

differential diagnosis of adults,

8. equip students with necessary knowledge, skills and attitudes required to perform primary care

prophylaxis and treatment,

9. equip students with necessary knowledge, skills and attitudes to refer Patient to advanced healthcare

units upon indication

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LEARNING OBJECTIVES

At the end of this clerkship, student should be able to;

KNOWLEDGE

1.0. recall necessary knowledge, related to body systems, on prevention of clinical conditions’

emergence, protection and improvement of health in healthy conditions,

2.0. at multi-system level or related to a body system, for clinical conditions which are frequent in community

and/or pose high risk for individual or community health, and/or life-threatening or constitute an emergency

2.1. recall necessary knowledge on risk factors, etiopathogenesis, physiopathology, and pathology,

2.2. recall knowledge on epidemiology,

2.3. recall knowledge on frequently encountered clinical complaints, symptoms, signs and findings,

2.4. recall necessary knowledge on health care processes, clinical decision making process, clinical

decisions and clinical practices, with performance measures, for managing at the level of primary health

care service,

2.5. recall knowledge on pharmacology of drugs that are effective at multi-system level, specifically on a

body system or on clinical conditions involving a specific body system,

SKILLS

3.0. do detailed questioning intended to explicate reasons of complaints

4.0. make Physical Examination including all organ systems

5.0. use diagnostic methods (laboratory and imaging techniques, other invasive or non-invasive methods)

correctly and cost-efficiently

6.0. perform minor medical interventions and applications (blood collection, i.v. or i.m. injection,

catheterization, capillary blood glucose testing, ECG, etc.)

ATTITUDES

7.0 show behaviours and attitudes appropriate for physician

8.0 prefer evaluation of Patient not only for major complaint but also as a whole

9.0 prefer detailed Physical Examination to search for main reason of illness

10.0 for differential diagnosis

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10.1 value importance of differential diagnosis based on frequencies and risks of illnesses

10.2. value using laboratory and clinical evaluations correctly and cost-efficiently

11.0 order consultation when needed or mandatory

12.0 organize appropriate interventions at primary care level, according to evidence based medical practices

13.0. refer Patient to appropriate center upon indication

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COMPETENCIES

14.0. take detailed and relevant history of adult Patient by good communication techniques

15.0. perform complete Physical Examination that includes all of organ systems

16.0 for diagnosis

16.1. order probable diagnoses

16.2. make differential diagnosis

17.0. assess results of laboratory or imaging tests (laboratory and imaging techniques, other invasive or

non-invasive methods)

18.0. assess diagnosis, differential diagnosis and emergency treatment requirements and methods

19.0 for emergency conditions

19.1. distinguish emergency conditions

19.2. give emergency treatment

20.0. inform Patients and Patient’s relatives on legal responsibility to take informed consent

21.0. apply evidence based medicine in internal medicine

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NCC 2014 – Essential Medical Procedures

(Internal Medicine)

Performance

Level

General and symptom-based history taking 3

Assessing mental status 3

Antropometric measurements 4

Head-Neck and ENT examination 3

Abdominal physical examination 3

Skin examination 3

General condition and vital signs assessment 4

Musculoskeletal system examination 3

Respiratory system examination 3

Cardiovascular system examination 3

Urologic examination 2

Preparing medical reports and notice 2

Preparing forensic report 2

Preparing epicrisis 3

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Preparing patient file 3

Obtaining informed consent 2

Writing prescription 2

Reading and evaluating direct radiographs 2

Taking and evaluating ECG 2

Measuring blood glucose level with glucometry 3

Filling laboratory request form 2

Preperation and evaluation of peripheral blood smear 2

Performing full urine analysis (including microscopic examination) and

evaluation 2

Interpretation of screening and diagnostic examination results 2

Rational drug use 2

Performing IM, IV, SC, ID injection 2

Urinary catheterization 2

Taking sample for culture 3

Nasogastric catheterization 2

Evaluating pulmonary function tests 2

Establishing IV line 2

Measuring blood pressure 4

Perfoming and assessing pulse oxymetry 2

Providing basic life support 2

Using and evaluating peak-flow meter 2

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YEDİTEPE UNIVERSITY

FACULTY OF MEDICINE

PHASE IV


ASSESSMENT TABLE

This table shows question types and assessment methods/tools used in training program.

Question Types (Pencil-Paper Tests) Proportion

(in Pencil-Paper Tests)

Multiple Choice Questions 36%

Extended Matching Questions 4%

Total 40%

Other Assessment Methods and Tools Proportion

(in Pass/Fail Decision)

Oral Exam (OE) 40%

Mini Clinical Evaluation Exercise (Mini-CEX) 5%

Logbook & Direct Observation of Procedural Skills (DOPS)

15%

Evaluation of Case Presentation (With Checklist)

Evaluation of Preparation Skills of Patient’s File (With Checklist)

Global Evaluation of Student’s Performance (With Checklist)

Total 60 %

Pass/Fail Decision Proportion

(in Pass/Fail Decision)

Pencil-Paper Tests 40%

Other Assessment Methods and Tools 60%

Total 100 %

Incomplete exam: Oral exam 50%, pencil-paper test 50%

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INTERNAL MEDICINE CLERKSHIP PROGRAM- GROUP A+B 26.10.2020 - 02.12.2020

WEEK 1 / October 26-30, 2020 (Online)

Monday

26-Oct-2020

Tuesday

27-Oct-2020

Wednesday

28-Oct-2020

Thursday

29-Oct-2020

Friday

30-Oct-2020

10.00 -10.45

Introductory Session

Introduction to Internal

Medicine Clerkship

Şahin Laçin

Lecture

Nutritional Anemia and

Interpretation of Peripheral

Blood Smear

Hasan Atilla Özkan

Independent Learning

National Holiday

Lecture

Bone Marrow Failure

Hasan Atilla Özkan

10.55 - 11.40

Lecture

Taking History

Arzu Güntürk

Lecture

Nutritional Anemia and

Interpretation of Peripheral

Blood Smear

Hasan Atilla Özkan

Independent Learning Lecture

Plasma Cell Dyscrasias

Hasan Atilla Özkan

12.00- 13.30 Lunch Lunch Lunch

13.30- 14.15

Lecture

Fever of Unknown Origin

Yaşar Küçükardalı

Lecture

Acute and Chronic

Leukemias

Hasan Atilla Özkan

National Holiday National Holiday

Lecture

Diagnosis and Management of

Hypercoagulapathy

Hasan Atilla Özkan

14.25 - 15.10

Lecture

Sepsis and Septic Shock


Lecture

Acute and Chronic

Leukemias

Hasan Atilla Özkan

Lecture

Approach to the Patients with

Lymphoproliferative Disorders

Lymphomas

Hasan Atilla Özkan

15.10 – 18.00 Independent Learning Independent Learning Independent Learning Independent Learning Independent Learning

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WEEK 2 / November 02-06, 2020 (Online)

Monday

2-Nov-2020

Tuesday

3-Nov-2020

Wednesday

4-Nov-2020

Thursday

5-Nov-2020

Friday

6-Nov-2020

10.00 -1 0.45

Lecture

Evidence Based Approach to

the Patient with Hypertensive

Disorders

Gülçin Kantarcı

Lecture

Approach to the Patient with

Glomerular Diseases

Gülçin Kantarcı

Lecture

Colorectal Cancer

Okan Kuzhan

Lecture

Management of Cancer Pain

Şahin Laçin

Lecture

Examination of Respiratory

System

Seha Akduman

10.55 - 11.40

Lecture

Hypertensive Disorders in

Pregnancy

Gülçin Kantarcı

Lecture


Glomerular Diseases

Gülçin Kantarcı

Lecture

Lung Cancer

Okan Kuzhan

Lecture

Principles of Chemotherapy

and Complications

Şahin Laçin

Lecture


Pulmonary System Symtoms

and Signs

Seha Akduman

12.00 - 13.30 Lunch Lunch Lunch Lunch Lunch

13.30 - 14.15

Lecture


the Patient with Chronic

Kidney Disease

Gülçin Kantarcı

Lecture

Stem Cell Transplantation

Hasan Atilla Özkan

Lecture

Breast Cancer

Okan Kzuhan

Lecture

Immunotherapy and targeted

Therapies in Oncology

Şahin Laçin

Lecture

Chronic Obstructive Lung

Disease and Corpulmonale

Seha Akduman

14.25 - 15.10

Lecture


the Patient with Chronic

Kidney Disease

Gülçin Kantarcı

Lecture

Evidence Based Screening

and Early Diagnosis in

Oncology

Okan Kuzhan

Lecture

Oncologic Emergencies

Şahin Laçin

Lecture

Hereditary Cancers and

Genetic Counselling in

Cancer; Basic Principles

Ayşegül Kuşkucu

Lecture

Asthma

Seha Akduman

15.30- 18.00 Independent Learning Independent Learning Independent Learning Independent Learning Independent Learning

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WEEK 3 / 09-13 November 2020 (Online)

Monday

9-Nov-2020

Tuesday

10-Nov-2020

Wednesday

11-Nov-2020

Thursday

12-Nov-2020

Friday

13-Nov-2020

10.00 -10.45

Lecture

Examination of the Abdomen

Cengiz Pata

Lecture

Liver Enzyme Disorder

Cengiz Pata

Lecture

Pulmonary Thromboembolism

Banu Musaffa Salepçi

Lecture

Examination of Extremities

Müge Bıçakçıgil Kalaycı

Lecture


Chronic Arthritis


10.55 - 11.40

Lecture

Ascites

Cengiz Pata

Lecture

Dysphagia

Cengiz Pata

Lecture

Environmental Lung Diseases


Lecture

Examination of Extremities


Lecture


Chronic Arthritis


12.00- 13.30 Lunch Lunch Lunch Lunch Lunch

13.30- 14.15

Lecture


the Patient Cirrhosis and

Complications of Cirrhosis

Cengiz Pata

Lecture

Gastrointestinal Bleeding

Cengiz Pata

Lecture


Pneumonia


Lecture


Connective Tissue Diseases


Lecture


Vasculitis


14.25 - 15.10

Lecture

Chronic Hepatitis

Cengiz Pata

Case Discussion

Oncology

Şahin Laçin

Lecture


Pneumonia


Lecture


Acute Arthritis

(Mono-oligo and

Polyarthritis)


Case Discussion

Rheumatology


15.30- 18.00 Independent Learning Independent Learning Independent Learning Independent Learning Independent Learning

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WEEK 4 / 16-20 November 2020 (Online)

Monday

16-Nov-2020

Tuesday

17-Nov-2020

Wednesday

18-Nov-2020

Thursday

19-Nov-2020

Friday

20-Nov-2020

10.00 -10.45

Lecture

Approach to Abdominal

Pain

Meltem Ergün

Lecture

Acute Complications of

Diabetes Mellitus

Hasan Aydın

Lecture

Metabolic Bone Disease

Hasan Aydın

Lecture

Hypoparathyroidism

Hasan Aydın

Lecture

Metabolic Syndrome

Hasan Aydın

10.55 - 11.40

Lecture

Approach to the Patient

with Diarre

Meltem Ergün

Lecture

Chronic Complications of

Diabetes Mellitus

Hasan Aydın

Lecture

Metabolic Bone Disease

Hasan Aydın

Lecture

Hyperthyroidism

Hasan Aydın

Lecture


Acid-Base Disorders

Gülçin Kantarcı


13.30- 14.15

Lecture

Cushing’s Syndrome

Hasan Aydın

Lecture

Treatment of Diabetes

Mellitus

Hasan Aydın

Lecture

Hyperparathyroidism

Hasan Aydın

Lecture

Goiter and Thyroid Cancer

Hasan Aydın

Lecture


Acid-Base Disorders

Gülçin Kantarcı

14.25 - 15.10

Lecture

Male Gonadal Diseases

Hasan Aydın

Lecture

Adrenal Insufficiency

Hasan Aydın

Case Discussion

Oncology

Okan Kuzhan

Case Discussion

Endocrinology

Hasan Aydın

Case Discussion

Nephrology

Gülçin Kantarcı


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WEEK 5 / 23 - 27 November 2020 (Online)

Monday

23-Nov-2020

Tuesday

24-Nov-2020

Wednesday

25-Nov-2020

Tuesday

26-Nov-2020

Friday

27-Nov-2020

10.00 -10.45

Lecture

Evidence-based Approach to

the Patient with Acute Kidney

Injury

Gülçin Kantarcı

Lecture

Examination of Head and

Neck

Arzu Güntürk

Lecture

Drug Interaction and

Examples of Prescriptions

Arzu Güntürk

Lecture

Non-Cardiac Causes of Chest

Pain


Lecture

Manegement of Elderly

Patients


10.55 - 11.40

Lecture

Evidence based Approach to

the Patient with Acute Kidney

Injury

Gülçin Kantarcı

Lecture

Management of

Hyperlipidemia

Arzu Güntürk

Lecture

Drug Interaction and

Examples of Prescriptions

Arzu Güntürk

Lecture

Non-Cardiac Causes of Chest

Pain


Lecture

Tuberculosis



13.30- 14.15

Lecture


Electrolyte Disorders

Gülçin Kantarcı

Lecture

Hypothyroidism

Hasan Aydın

Case Discussion

General Internal Medicine

Arzu Güntürk

Lecture

Acute Respiratory Distress

Syndrome


Case Discussion

Chest Diseases

Seha Akduman

14.25 - 15.10

Case Discussion

Gastroenterology

Cengiz Pata

Case Discussion

Hematology

Hasan Atilla Özkan

Case Discussion

Gastroenterology

Meltem Ergün

Case Discussion

General Internal Medicine


Case Discussion

Chest Diseases



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WEEK 5.5 / 30 November - 02 December 2020 (Online)

Monday

30-Nov-2020

Tuesday

01-Dec-2020

Wednesday

02-Dec-2020

10.00 -10.45

Independent Learning Independent Learning

Independent Learning

10.55 - 11.40 Independent Learning

12.00- 13.30 Lunch Lunch Lunch

13.30- 14.15

Independent Learning Independent Learning

Assessment Session

14.25 - 15.10

Program Evaluation Session

Review of the Exam Questions,

Evaluation of the Clearkship Program

15.10 – 18.00

Documents

FACULTY OF MEDICINE PHASE IV INTERNAL MEDICINE CLERKSHIP